medicaid advisor: a personal story

Be Prepared To Cover

Long-Term Care BY COLIN SANDLER

In 2021, my mother suddenly went from fully functioning to needing total care due to a stroke. Despite my professional years in this landscape, I found myself less than optimally prepared.

Here are my take-aways from the experience:

1) HAVE A POWER OF ATTORNEY (POA) which is approved by all the financial institutions prior to the person losing capacity. Prepared by a skilled elder law attorney, I was able to use the POA at our local bank but the financial institution holding her IRA refused to accept any POA other than their own (form). As my mother could no longer sign, I now have no access to this account. So, make sure your financial institutions will accept your POA! If you don’t have one and/or cannot access needed assets, you may be forced to apply for a guardianship. This is expensive and time consuming—and there is no guarantee a family member will be appointed to make critical decisions.

2) MEDICARE DOES NOT COVER EVERYTHING! A traditional supplement plan often covers co-pays, deductibles and, most importantly, the Medicare rehab copay. This starts on day 21 in a rehab center and the cost in 2023 will be $200 a day. If you have a Medicare Advantage Plan (MAP), you are likely to have co-pays, deductibles, and limited coverage of co-pays in rehab. Luckily, I knew I could change my mother from a MAP to traditional Medicare outside of the open enrollment period because she was in a rehab center. I moved her over to original Medicare and a supplement plan–within eight days of her MAP deciding she was not improving and would be completely cutting her coverage. Thankfully, the new insurance started on day seven and she was able to remain in the facility for the full 100 days, during which time she improved significantly, and at no cost to us!

3) DOES YOUR LOVED ONE HAVE LONG-TERM CARE INSURANCE? If they do, understand the benefits. What is the daily rate cap (which can be different for home care, assisted living or a nursing home)? What is the lifetime cap? How long is the elimination period? The answers can impact the decisions you make. Unfortunately, most people do not have long-term care insurance so the only options are private pay or Medicaid. Medicare does not pay for long term care. It would be ideal to get educated about Medicaid prior to needing long term care but most people are reactive—not proactive. So, the next best thing is to meet with an expert early on in that reactive stage to try and reduce the out-of-pocket costs. My mom has great long-term care insurance but not enough to cover her needs. So we are using the insurance to help cover an enhanced assisted living and then using Medicaid to cover the extra care she still requires.

4) UNDERSTAND MEDICAID FOR HOME CARE. Nursing home care is straightforward. Once approved, Medicaid pays for all your care. Home care is very different. You have to go through two NY State independent assessments and then pick a Managed LongTerm Care (MLTC) Plan. Very often people do not get approved for the hours they need and do not know how to go through the process of fighting for more coverage. An alternate long-term home care program, the Nursing Home Transition and Diversion program (NHTD), is better geared towards people with dementia and supervisionbased needs. Due to planning and despite having some assets and a good income, I was able to get my mother qualified for Medicaid and into a home care program via Medicaid that meets her needs.

My best advice: Sort through all these issues sooner rather than later!

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Colin Sandler, LCSW, CCM, is the owner of Medicaid Solutions and has been providing advice on aging to seniors and their families for over 20 years. Call 914-924-2566 or email Colin@ Medicaidsolutions.com; 2127 Crompond Rd, Cortlandt Manor, NY.

Westchester's Bee-Line Bus System

around Westchester, and is a fully accessible bus service with senior reduced fares and free transfers?

If you said the Westchester Bee-Line System, you’re correct! With over 3,300 bus stops and close to 60 routes, the Bee-Line bus

Yet, many older adults are not familiar with how to ride the Bee-Line and overlook the

So, here are some helpful facts you should know about the Bee-Line System:

PAYING YOUR FARE:

If you are at least 65 years old, you pay a reduced fare of $1.35 per ride. For easier travel, apply for a Reduced Fare MetroCard that is personalized with your name and photograph. To apply for a Reduced Fare MetroCard visit the MetroCard van when it's in Westchester, the third week of every

date of birth. Call the Westchester SMART commute program at 914-995-4444 for

and the MetroCard van schedule.

FULLY ACCESSIBLE SERVICE:

Why take a bigger step than you need to?

sible bus service, making it easier for you to board and exit the bus. Every Bee-Line bus can “kneel,” which means that the entrance can be lowered to shorten the distance you have to step to board the bus. Each bus is also equipped with a

happy to kneel the bus for you and make it much easier to step on board. If you cannot use stairs, the Bee-Line bus driver

on board. You must ask the driver to use

wheelchair or in a scooter, the driver will

needs. For your safety, always remember to hold the handrails.

USING YOUR REDUCED FARE METROCARD:

There are three ways you can use your Reduced Fare MetroCard: 1.Show it to your bus driver as your ID and pay your fare with exact change. 2.Add money to your Reduced Fare MetroCard and use it as a debit card. 3. -

Please have your Reduced Fare MetroCard out and ready before you board the bus.

USING COINS TO PAY YOUR FARE:

Dollar bills and pennies cannot be used in the fare box. If using coins, please have exact change ready when boarding the bus, as bus drivers are unable to make change.

FREE TRANSFERS:

Your bus fare includes one free transfer to other Bee-Line buses and to MTA subways and local buses in the Bronx. If paying with coins, ask the driver for your transfer

only be used for bus to bus transfers. If you are using a MetroCard, your transfer will register electronically when you dip your card into the fare box.

GETTING INFORMATION:

For individuals who enjoy using a computer, you can visit the Bee-Line online at www.westchestergov.com/beelinebus to accesses bus schedules, maps and general

If a phone call is more your style, a dedi-

call away, at 914-813-7777, Monday through Friday from 8 a.m. to 4 p.m. An automated phone system is also available 24 hours per day.